The objective of this proposed research is to develop, evaluate, and disseminate a comprehensive developmental day care program for profoundly retarded, non-ambulatory individuals, which could easily be extended to a 24-hour-a-day program, and which can be replicated in a variety of residential and day care facilities to provide clients with a consistently high quality of health care, personal attention, and developmental program implementation. To accomplish this objective, the following activities are proposed. First Year: Collect baseline data on the quality of health care, personal attention, and developmental interactions being provided, and on the current levels and rates of individual residents' development; such data will be collected throughout the proposed 3-year project. Simultaneously, refinements and some adaptations (to fit newly rennovated facilities), will be made in the hardware (e.g. bathing prosthetics) and software (e.g. supervisory) and quality control procedures) developed during 1 1/2 years of pilot work. During the first year, the refined technology will be implemented in one unit of 20 residents. Second Year: Continued development, evaluation, and refinement of hardware and software. Early in the second year, the total program will be introduced into a second unit of 20 residents with different staff; later in the second year or early in the third year, the program will be implemented in a third unit of 20 residents. Third Year: Though refinement and evaluation of the accumulated technology will continue, emphasis will be placed on overall project evaluation and dissemination of research findings (e.g. developmental gains produced ) and products (e.g. prosthetic devices and software). A comprehensive manual, detailing the total technology developed in this project will be prepared and distributed to allow replication in a variety of residential and day care facilities.